Classifications

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  • A61B5/0073—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence by tomography, i.e. reconstruction of 3D images from 2D projections
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  • A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
  • A61B5/0082—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes
  • A61B5/0084—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes for introduction into the body, e.g. by catheters
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  • A61B8/52—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves
  • A61B8/5215—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves involving processing of medical diagnostic data
  • A61B8/5223—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves involving processing of medical diagnostic data for extracting a diagnostic or physiological parameter from medical diagnostic data
• • A—HUMAN NECESSITIES
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  • A61B8/52—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves
  • A61B8/5215—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves involving processing of medical diagnostic data
  • A61B8/5238—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves involving processing of medical diagnostic data for combining image data of patient, e.g. merging several images from different acquisition modes into one image
  • A61B8/5261—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves involving processing of medical diagnostic data for combining image data of patient, e.g. merging several images from different acquisition modes into one image combining images from different diagnostic modalities, e.g. ultrasound and X-ray
• • G—PHYSICS
  • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
  • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
  • G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
  • G16H50/30—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for calculating health indices; for individual health risk assessment
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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  • A61B2034/107—Visualisation of planned trajectories or target regions
• • A—HUMAN NECESSITIES
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  • A61B8/44—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device
  • A61B8/4416—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device related to combined acquisition of different diagnostic modalities, e.g. combination of ultrasound and X-ray acquisitions
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
  • A61B8/46—Ultrasonic, sonic or infrasonic diagnostic devices with special arrangements for interfacing with the operator or the patient
  • A61B8/461—Displaying means of special interest
  • A61B8/465—Displaying means of special interest adapted to display user selection data, e.g. icons or menus
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
  • A61B8/46—Ultrasonic, sonic or infrasonic diagnostic devices with special arrangements for interfacing with the operator or the patient
  • A61B8/467—Ultrasonic, sonic or infrasonic diagnostic devices with special arrangements for interfacing with the operator or the patient characterised by special input means
  • A61B8/469—Ultrasonic, sonic or infrasonic diagnostic devices with special arrangements for interfacing with the operator or the patient characterised by special input means for selection of a region of interest
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
  • A61F2/02—Prostheses implantable into the body
  • A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
  • A61F2/06—Blood vessels
  • A61F2/07—Stent-grafts

Definitions

• the display device is further configured to display, on the single screen, a percentage of narrowing of the body lumen within the area of interest.
• the controller may be further configured to automatically determine an optimal location for a stent based on the received image data.
• the display device may be further configured to display the optimal location on the longitudinal view of the body lumen.
• the devices, systems, and methods described herein can include one or more features described in U.S. Provisional App. No. 62/643105 , filed on an even date herewith, U.S. Provisional App. No. 62/642847 , filed on an even date herewith, U.S. Provisional App. No. 62/712009 , filed on an even date herewith, and U.S. Provisional App. No. 62/711927 , filed on an even date herewith.
• the intraluminal imaging system 100 can be any type of imaging system suitable for use in the lumens or vasculature of a patient.
• the intraluminal imaging system 100 is an intraluminal ultrasound (IVUS) imaging system.
• the intraluminal imaging system 100 may include systems configured for forward looking intraluminal ultrasound (FL-IVUS) imaging, intraluminal photoacoustic (IVPA) imaging, intracardiac echocardiography (ICE), transesophageal echocardiography (TEE), and/or other suitable imaging modalities.
• FL-IVUS forward looking intraluminal ultrasound
• IVPA intraluminal photoacoustic
• ICE intracardiac echocardiography
• TEE transesophageal echocardiography
• the system 100 and/or device 102 can be configured to obtain any suitable intraluminal imaging data.
• the device 102 can include an imaging component of any suitable imaging modality, such as optical imaging, optical coherence tomography (OCT), etc.
• the device 102 can include any suitable imaging component, including a pressure sensor, a flow sensor, a temperature sensor, an optical fiber, a reflector, a mirror, a prism, an ablation element, a radio frequency (RF) electrode, a conductor, and/or combinations thereof.
• the device 102 can include an imaging element to obtain intraluminal data associated with the lumen 120.
• the device 102 may be sized and shaped (and/or configured) for insertion into a vessel or lumen 120 of the patient.
• the system 100 may be deployed in a catheterization laboratory having a control room.
• the processing system 106 may be located in the control room.
• the processing system 106 may be located elsewhere, such as in the catheterization laboratory itself.
• the catheterization laboratory may include a sterile field while its associated control room may or may not be sterile depending on the procedure to be performed and/or on the health care facility.
• the catheterization laboratory and control room may be used to perform any number of medical imaging procedures such as angiography, fluoroscopy, CT, IVUS, virtual histology (VH), forward looking IVUS (FL-IVUS), intraluminal photoacoustic (IVPA) imaging, a fractional flow reserve (FFR) determination, a coronary flow reserve (CFR) determination, optical coherence tomography (OCT), computed tomography, intracardiac echocardiography (ICE), forward-looking ICE (FLICE), intraluminal palpography, transesophageal ultrasound, fluoroscopy, and other medical imaging modalities, or combinations thereof.
• device 102 may be controlled from a remote location such as the control room, such than an operator is not required to be in close proximity to the patient.
• the intraluminal device 102, PIM 104, and monitor 108 may be communicatively coupled directly or indirectly to the processing system 106. These elements may be communicatively coupled to the medical processing system 106 via a wired connection such as a standard copper link or a fiber optic link and/or via wireless connections using IEEE 802.11 Wi-Fi standards, Ultra Wide-Band (UWB) standards, wireless FireWire, wireless USB, or another high-speed wireless networking standard.
• the processing system 106 may be communicatively coupled to one or more data networks, e.g., a TCP/IP-based local area network (LAN). In other embodiments, different protocols may be utilized such as Synchronous Optical Networking (SONET).
• SONET Synchronous Optical Networking
• the scanner assembly 110 can be a one-dimensional array or a two-dimensional array in some instances.
• the scanner assembly 110 can be a rotational ultrasound device.
• the active area of the scanner assembly 110 can include one or more transducer materials and/or one or more segments of ultrasound elements (e.g., one or more rows, one or more columns, and/or one or more orientations) that can be uniformly or independently controlled and activated.
• the active area of the scanner assembly 110 can be patterned or structured in various basic or complex geometries.
• the scanner assembly 110 can be disposed in a side-looking orientation (e.g., ultrasonic energy emitted perpendicular and/or orthogonal to the longitudinal axis of the intraluminal device 102) and/or a forward-looking looking orientation (e.g., ultrasonic energy emitted parallel to and/or along the longitudinal axis).
• the scanner assembly 110 is structurally arranged to emit and/or receive ultrasonic energy at an oblique angle relative to the longitudinal axis, in a proximal or distal direction.
• ultrasonic energy emission can be electronically steered by selective triggering of one or more transducer elements of the scanner assembly 110.
• the ultrasound transducer(s) of the scanner assembly 110 can be a piezoelectric micromachined ultrasound transducer (PMUT), capacitive micromachined ultrasonic transducer (CMUT), single crystal, lead zirconate titanate (PZT), PZT composite, other suitable transducer type, and/or combinations thereof.
• the ultrasound transducer array 124 can include any suitable number of individual transducers between 1 transducer and 1000 transducers, including values such as 2 transducers, 4 transducers, 36 transducers, 64 transducers, 128 transducers, 500 transducers, 812 transducers, and/or other values both larger and smaller.
• the PIM 104 transfers the received echo signals to the processing system 106 where the ultrasound image (including the flow information) is reconstructed and displayed on the monitor 108.
• the console or processing system 106 can include a processor and a memory.
• the processing system 106 may be operable to facilitate the features of the intraluminal imaging system 100 described herein.
• the processor can execute computer readable instructions stored on the non-transitory tangible computer readable medium.
• the PIM 104 facilitates communication of signals between the processing system 106 and the scanner assembly 110 included in the intraluminal device 102. This communication may include providing commands to integrated circuit controller chip(s) within the intraluminal device 102, select particular element(s) on the transducer array 124 to be used for transmit and receive, providing the transmit trigger signals to the integrated circuit controller chip(s) to activate the transmitter circuitry to generate an electrical pulse to excite the selected transducer array element(s), and/or accepting amplified echo signals received from the selected transducer array element(s) via amplifiers included on the integrated circuit controller chip(s). In some embodiments, the PIM 104 performs preliminary processing of the echo data prior to relaying the data to the processing system 106.
• the PIM 104 performs amplification, filtering, and/or aggregating of the data. In an embodiment, the PIM 104 also supplies high- and low-voltage DC power to support operation of the intraluminal device 102 including circuitry within the scanner assembly 110.
• the IVUS data and/or the external ultrasound data may be co-registered with the 2D or 3D CT image, which may further improve placement accuracy and decrease procedural time.
• the placement of the intraluminal device 102 may be verified with this multi-imaging system, which may improve outcomes versus standard fluoroscopic guidance.
• the intraluminal device 102 is tracked to the target location as identified on a CT image and/or angiogram (such as a lesion or aneurysm).
• a roadmap produced from co-registered IVUS and CT image data may be correlated to fluoroscopic data to further improve accuracy.
• the processing system 106 may create an imaging loop based on the roadmap and fluoroscopic data to improve the navigation of the intraluminal device 102 through the vessels of the patient.
• the processing system 106 receives echo data from the scanner assembly 110 by way of the PIM 104 and processes the data to reconstruct an image of the tissue structures in the medium surrounding the scanner assembly 110.
• the device 102 can be utilized within any suitable anatomy and/or body lumen of the patient.
• the processing system 106 outputs image data such that an image of the vessel or lumen 120, such as a cross-sectional IVUS image of the lumen 120, is displayed on the monitor 108.
• Lumen 120 may represent fluid filled or surrounded structures, both natural and man-made. Lumen 120 may be within a body of a patient.
• Lumen 120 may be a blood vessel, as an artery or a vein of a patient's vascular system, including cardiac vasculature, peripheral vasculature, neural vasculature, renal vasculature, and/or or any other suitable lumen inside the body.
• the device 102 may be used to examine any number of anatomical locations and tissue types, including without limitation, organs including the liver, heart, kidneys, gall bladder, pancreas, lungs; ducts; intestines; nervous system structures including the brain, dural sac, spinal cord and peripheral nerves; the urinary tract; as well as valves within the blood, chambers or other parts of the heart, and/or other systems of the body.
• the device 102 may be used to examine man-made structures such as, but without limitation, heart valves, stents, shunts, filters and other devices.
• the controller or processing system 106 may include a processing circuit having one or more processors in communication with memory and/or other suitable tangible computer readable storage media.
• the controller or processing system 106 may be configured to carry out one or more aspects of the present disclosure.
• the processing system 106 and the monitor 108 are separate components.
• the processing system 106 and the monitor 108 are integrated in a single component.
• the system 100 can include a touch screen device, including a housing having a touch screen display and a processor.
• the system 100 can include any suitable input device, such as a touch sensitive pad or touch screen display, keyboard/mouse, joystick, button, etc., for a user to select options shown on the monitor 108.
• the processing system 106, the monitor 108, the input device, and/or combinations thereof can be referenced as a controller of the system 100.
• the controller can be in communication with the device 102, the PIM 104, the processing system 106, the monitor 108, the input device, and/or other components of the system 100.
• the processing system 106 may be configured to automatically measure landmarks or key luminal areas within a lumen. These landmarks may include borders of tissue layers (such as a lumen or vessel border). The dimensions of these landmarks may be automatically measured by the processing system 106. These measurements may be displayed on one or more images of the lumen. In some embodiments, the measurements may be used to identify lesions within the lumen and determine the severity and extent of these lesions. The identification and measurement these landmarks may a user to easily visualize a lumen within the patient and accurately assess the severity and extent of lesions therein. This may add confidence to the assessment of lesions and save time in measurement procedures.
• the transmission line bundle 112 terminates in a PIM connector 114 at a proximal end of the intraluminal device 102.
• the PIM connector 114 electrically couples the transmission line bundle 112 to the PIM 104 and physically couples the intraluminal device 102 to the PIM 104.
• the intraluminal device 102 further includes a guidewire exit port 116. Accordingly, in some instances the intraluminal device 102 is a rapid-exchange catheter.
• the guidewire exit port 116 allows a guidewire 118 to be inserted towards the distal end in order to direct the intraluminal device 102 through the lumen 120.
• the monitor 108 may be a display device such as a computer monitor or other type of screen.
• the monitor 108 may be used to display selectable prompts, instructions, and visualizations of imaging data to a user.
• the monitor 108 may be used to provide a procedure-specific workflow to a user to complete an intraluminal imaging procedure.
• This workflow may include performing a pre-stent plan to determine the state of a lumen and potential for a stent, as well as checking on a stent that has been positioned in a lumen.
• the workflow may be presented to a user as any of the displays or visualizations shown in Figs. 2-7 .
• Fig. 2 shows an exemplary display 200 showing a prompt 202 according to aspects of the present disclosure.
• the display 200 is displayed on the monitor 108 as shown in Fig. 1 .
• the display 200 is displayed on a screen of another device, such as PIM 104.
• the display 200 may be generated by a controller of the intraluminal imaging system 100.
• the display 200 is configured to display prompts and instructions as well as other data to an operator.
• the display 200 may be used to show a complete end-to-end workflow for an intraluminal procedure. This workflow may include a number of prompts and instructions that may guide an operator through a procedure. This may simplify the steps of a procedure and help to avoid operator errors.
• the appearance of the visualization 304 may be altered when one of the regions is selected by the operator.
• the selected artery may be outlined, highlighted, or colored with a different color.
• the selected artery is outlined in blue, as shown in Fig. 4 .
• the instructions 403 may instruct an operator to push the device 102 a given distance along the selected target vessel.
• a visualization 404 corresponding to the instructions 403 may also be displayed on the display 200.
• the visualization 404 includes a blue line 406 with arrows showing the direction in which the pullback procedure should be performed.
• the visualization 404 may include visual effects such as changing colors or animation.
• the arrows of the visualization 404 may move in the direction specified by the instructions 403.
• the instructions 403 and visualization 404 may vary depending on options that were previously selected. For example, if an operator selected the RCA as the target vessel, the visualization 404 of the RCA would be highlighted and a corresponding visualization would be displayed showing a procedure outlined by instructions 403.
• the instructions 403 of the display 200 may vary depending on which option 204, 206 was selected from the prompt 202 shown in Fig. 2 .
• the instructions may read "please perform pullback from the distal point of the stent to the proximal point of the stent.”
• Other instructions may also be included to guide the operator to perform an imaging procedure and acquire imaging data relevant to the selected target vessel and/or stent.
• measurements are performed automatically on the imaging data with a controller of the intraluminal imaging system 100 as the imaging data is acquired by the device 102.
• Existing imaging systems typically require an operator to manually select a frame of interest and mark areas for measurement. This may be a time-consuming process, and may introduce user errors and require a high level of expertise, especially in marking areas for measurement. These errors may cause operators to miss important features within the imaging data, such as lesions.
• the intraluminal imaging system 100 provides automated measurement of features in received imaging data without requiring user interaction.
• a vessel boundary 608 and a minimum lumen area (MLA) 606 are displayed on the first view 604.
• the measurements may also include lumen or vessel diameter, lumen or vessel area, lumen or vessel eccentricity, center measurements of the lumen or vessel, lumen or vessel boundary thickness, and other measurements performed automatically by the controller. These measurements may also be shown on other views.
• a marker 614 is placed at the MLA in the second view 610 that corresponds with the lumen border 606 of the MLA in the first view 604. This may help an operator to visualize the diameter of vessel boundaries along the lumen 120.
• the measurements may be displayed in numerical format at box 612 on the visualization 310. Specific portions and views of the visualization 300 may be viewed by an operator by selecting the options 620, 622, and 624.
• Measurements and/or metrics corresponding to the imaging data may be performed automatically by the intravascular imaging system and displayed by the visualization 300.
• the intraluminal imaging system 100 may be used to perform length measurements such as minimum, maximum, average, and mean lengths of features in the imaging data.
• the effective diameter of features may also be measured.
• Area measurements of features such as lumens, vessels, plaque, and thrombus may be performed by the intraluminal imaging system 100.
• the measurements may include plaque burden, percent stenosis, percent difference, diameter stenosis, percent diameter stenosis, luminal gain, and luminal gain percentage.
• the landing spot 834 may mark an area of the lumen recommended for treatment, such as placing a stent or positioning a balloon.
• the landing spot 834 may be automatically recommended by the system 100 based on the received imaging data received by the device 102.
• the landing spot 834 may be shown in profile in view 610 to show the potential placement of the stent within the landing spot 834.
• a distal end marker 830 and a proximal end marker 832 of the landing spot 834 may define the recommended placement of a distal and proximal edge of a stent to be placed in the lumen.
• the distal end marker 830 and proximal end marker 832 may be accompanied with numerical data 820, 822 illustrating the average diameter and plaque burden of the lumen 120 at these locations.
• the visualization may also a depiction of the plaque burden 852 along the lumen 120.
• the depiction of the plaque burden 852 is automatically measured based on imaging data from the device 102.
• the visualization 700 may also include a depiction of lumen area 850. As illustrated in Fig. 7 , the marker 614 for the MLA may be placed where the plaque burden is the greatest and the area of the lumen is the smallest.
• the visualization 700 includes a recommended stent diameter as shown in text box 812. This diameter may be based on the diameter of the lumen 102 as measured by the system 100.
• Fig. 8 shows an exemplary visualization 800 according to aspects of the present disclosure.
• the visualization 800 may be generated by the system 100 and displayed on a monitor 108.
• the visualization 800 may include a longitudinal view 910 of a lumen and a transverse view 920 of a lumen.
• the views 910, 920 of the lumen include intraluminal imaging data, such as IVUS data received from a device 102 as shown in Fig. 1 .
• the longitudinal view 910 of the lumen may be selected from an option list 930 including a classic longitudinal view 932 (as shown in Fig. 8 ), a percent stenosis view 934 (as shown in Fig. 9 ), a landing spot view 936 (as shown in Fig.
• the transverse view 920 may also be referred to a 2D tomographic view, and may correspond to a position along the longitudinal view 910, such as at a minimum lumen area (MLA).
• Various reference points 912, 914, 916 may be displayed on the longitudinal view 910, including a distal reference point 912, a MLA reference point 914, and a proximal reference point 916.
• the system 100 may automatically identify landmarks (or key luminal areas) within the views 910, 920 of the visualization 800.
• the system 100 may automatically detect landmarks within each frame of the views 910, 920 and measure the dimensions of these landmarks. For example, the system may automatically detect and measure the diameter of and area within a vessel border 608 and a lumen border 606 of the lumen in the transverse view 920, as well as the length of the lumen in the longitudinal view 910. These measurements may be used to automatically identify one or more lesions within the lumen.
• the MLA reference point 914 may be identified as a lesion
• the distal and proximal reference points 912, 916 may be identified as a distal and proximal edge of the lesion, respectively.
• the area between the vessel border 608 and the lumen border 606 may be shown as highlighted area 904.
• These automatic measurements may be displayed on the visualization 800, such as in text boxes 940, 942.
• a user may select a view report icon 944 to view a report including all of the calculated measurements. This icon 944 may be used to automatically store the measurement in file of the patient.
• Fig. 9 shows an exemplary visualization 900 according to aspects of the present disclosure.
• the visualization 900 may be generated by the system 100 and displayed on a monitor 108.
• the visualization 900 may include a longitudinal view 910 and a transverse (or cross-sectional) view 920 of a lumen.
• the longitudinal view 910 may be a percent stenosis longitudinal view 934, such that the system 100 is configured to automatically calculate a percent stenosis across the lumen or a segment of the lumen compared to a reference frame.
• the system 100 has automatically measured each frame of imaging data in visualization 900 to determine the percent stenosis across the entire lumen as 70% and across the segment between the distal reference point 912 and the proximal reference point 916 as 60% (as shown in text box 950).
• the visualization 900 may also display the percent stenosis at the distal, MLA, and proximal reference points 912, 914, 916. These features may also be manually adjusted by the user.
• the position of the transverse view 920 may be manually selected by a user.
• a sliding reference point 918 may be included in the longitudinal view 910 that may show the position of the transverse view 920. The user may slide this sliding reference point 918 to view any position along the length of the lumen. The position of the sliding reference point 918 along the lumen may be displayed in text box 940, as well as the area and diameter of the lumen at the sliding reference point 918.
• Fig. 10 shows an exemplary visualization 1000 according to aspects of the present disclosure.
• the visualization 1000 may be generated by the system 100 and displayed on a monitor 108.
• the visualization 1000 may include a longitudinal view 910 and a transverse view 920 of a lumen.
• the longitudinal view 910 may be a "landing spot" longitudinal view 936, such that the system 100 is configured to automatically identify a lumen and recommend a landing spot for placement of a stent.
• the system 100 has automatically identified an MLA reference point 914 as the center of a lesion within the lumen.
• the visualization 1000 includes a recommended landing spot 834 based on the position of the detected lesion.
• the edges of the recommended landing spot 834 may be marked by distal and proximal reference points 912, 916. These points 912, 916 may be manually adjusted by the user.
• Fig. 11 shows an exemplary visualization 1100 according to the present invention.
• the visualization 1100 is generated by the system 100 and displayed on a monitor 108.
• the visualization 1100 is configured such that it can display a longitudinal view 910 and a 2D/3D hybrid view 1110.
• a user is able to select the 2D/3D hybrid view option 938, or use a control button or handle to display the 2D/3D hybrid view 1110 on the monitor 108.
• a transverse view 920 (or 2D tomographic view), such as that shown in Figs. 5-10 , may be used to generate the 2D/3D hybrid view 1110 based on a selection of the user.
• the 2D/3D hybrid view 1110 may be generated by the system 100 by combining measurements of the lumen or vessel borders from a plurality of image frames.
• the 2D/3D hybrid view 1110 is generated using 500-2,500 image frames.
• the 2D/3D hybrid view 1110 is generated using 10-100 image frames, 200-500 image frames, 500-1,000 image frames, 1,000-2,000 image frames, or 5,000-10,000 image frames.
• the 2D/3D hybrid view 1110 includes a transverse view 920 of the lumen and a 3D portion 1130 extending out from the transverse view 920.
• the 2D/3D hybrid view 1110 may include a lumen border 1120 in the transverse view 920 and extending into the 3D portion 1130 of the view 1110.
• the 2D/3D hybrid view 1110 may include indicators 1114, 1116 corresponding to positions on the longitudinal view 910 (such as the MLA reference point 914 and the proximal reference point 916).
• the 2D/3D hybrid view 1110 may also include any of key luminal areas or landmarks as discussed above.
• the 2D/3D hybrid view 1110 may rotated or enlarged by a user to view different regions of the lumen.
• the user may also select different positions along the longitudinal view 910 as the starting point of the 2D/3D hybrid view (such as showing a transverse view 920 corresponding to the MLA or distal reference points 914, 916).
• the 2D/3D hybrid view 1110 may provide a user a view of imaging data along the length of the lumen that is easy to understand.
• Fig. 12 is a flow diagram of a method 1200 of providing intraluminal imaging to measuring and display features in a lumen to a user.
• the steps of the method 1200 may be carried out by the intraluminal imaging system 100 and associated components as shown in Fig. 1 and any of the displays as shown in Figs. 5-11 . It is understood that the steps of method 1200 may be performed in a different order than shown in Fig. 12 , additional steps can be provided before, during, and after the steps, and/or some of the steps described can be replaced or eliminated in other embodiments.
• the method 1200 may include providing a prompt to navigate an intraluminal imaging device within a lumen.
• the intraluminal imaging device may be the intraluminal imaging device 102 as shown in Fig. 1 .
• the prompt may include navigating the intraluminal imaging device to a starting point in the lumen, as well as activating sensors in the intraluminal device. This prompt may be presented with text as well as images showing where the user should place the intraluminal device.
• the method 1200 may include receiving imaging data from the intraluminal device.
• This imaging data may help a user to accurately navigate the intraluminal device according to the prompt of step 1202.
• the imaging data may show imaging data from the intraluminal device as it is moved through the lumen.
• the imaging data may include IVUS data showing the layers of tissue on the interior of the lumen.
• the imaging data includes data from another modality such as angiographic image data. This data may be used to compile an angiographic image of the lumen.
• the imaging data may help the user to accurately perform the operation outlined in the prompt.
• the method 1200 may include automatically measuring features in the image frames.
• a controller of the system may automatically identify and measure these features based on imaging data.
• the measured features in the image frames may include anatomical features such as tissue boundaries (such as lumen and vessel boundaries), lesions, aneurisms, bifurcations, as well as manmade features such as stents.
• the automatic measurements may include lumen or vessel diameter, lumen or vessel area, lumen or vessel eccentricity, center measurements of the lumen or vessel, lumen or vessel boundary thickness, pressure measurements, percent stenosis, malapposition areas, landing spots, and other measurements performed by the controller.
• the system identifies a lesion within the lumen and automatically measures at least three points of the lesion: a proximal reference point, a distal reference point, and a MLA.
• the controller identifies the features based on variations in the imaging data, such as changes in brightness, speckle patterns, regions with similar shapes, linear or curved features, as well as other variations.
• the controller identifies the features based on previous user testing, clinical trials, published guidelines, and consensus in the medical field.
• the automatic measurements of the system may be manually adjusted or edited by the user. For example, the user may change a lumen boundary to correct an error in measurement.

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